title: Overcoming drug resistance in pancreatic cancer.
abstract: BACKGROUND
  Pancreatic cancer has the worst survival rate of all cancers. The current standard care for metastatic pancreatic cancer is gemcitabine, however, the success of this treatment is poor and overall survival has not improved for decades. Drug resistance (both intrinsic and acquired) is thought to be a major reason for the limited benefit of most pancreatic cancer therapies.
  
  
  METHODS
  Previous studies have indicated various mechanisms of drug resistance in pancreatic cancer, including changes in individual genes or signaling pathways, the influence of the tumor microenvironment, and the presence of highly resistant stem cells. This review summarizes recent advances in the mechanisms of drug resistance in pancreatic cancer and potential strategies to overcome this.
  
  
  CONCLUSIONS
  Increasing drug delivery efficiency and decreasing drug resistance is the current aim in pancreatic cancer treatment, and will also benefit the treatment of other cancers. Understanding the molecular and cellular basis of drug resistance in pancreatic cancer will lead to the development of novel therapeutic strategies with the potential to sensitize pancreatic cancer to chemotherapy, and to increase the efficacy of current treatments in a wide variety of human cancers.
authors.affiliation: Baylor College of Medicine, Molecular Surgeon Research Center, Elkins Pancreas Center, Michael E. DeBakey Department of Surgery, Houston, Texas 77030, USA.
authors.forename: Jiang
authors.initials: J
authors.lastname: Long
authors.forename: Yuqing
authors.initials: Y
authors.lastname: Zhang
authors.forename: Xianjun
authors.initials: X
authors.lastname: Yu
authors.forename: Jingxuan
authors.initials: J
authors.lastname: Yang
authors.forename: Drake G
authors.initials: DG
authors.lastname: LeBrun
authors.forename: Changyi
authors.initials: C
authors.lastname: Chen
authors.forename: Qizhi
authors.initials: Q
authors.lastname: Yao
authors.forename: Min
authors.initials: M
authors.lastname: Li
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D019008:Drug Resistance, Neoplasm / Q000235:genetics; D058750:Epithelial-Mesenchymal Transition; D006801:Humans; D009154:Mutation; D010190:Pancreatic Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D015398:Signal Transduction
chemical_list: D000970:Antineoplastic Agents